Disulfiram-like drug

Disulfiram-like drug
Drug class
Disulfiram, the prototypical drug of this class.
Class identifiers
SynonymsAlcohol sensitizers; Alcohol-sensitizing agents; Alcohol-deterrent drugs; Acetaldehyde dehydrogenase inhibitors
UseAlcoholism
Biological targetAcetaldehyde dehydrogenase, others
Legal status
In Wikidata

A disulfiram-like drug is a drug that causes an adverse reaction to alcohol leading to nausea, vomiting, flushing, dizziness, throbbing headache, chest and abdominal discomfort, and general hangover-like symptoms among others.[1][2] These effects are caused by accumulation of acetaldehyde, a major but toxic metabolite of alcohol formed by the enzyme alcohol dehydrogenase.[1][2] The reaction has been variously termed a disulfiram-like reaction, alcohol intolerance, and acetaldehyde syndrome.[3]

The prototypical drug of this group is disulfiram (brand name Antabuse), which acts as an acetaldehyde dehydrogenase inhibitor, preventing the metabolism of acetaldehyde into acetic acid, and is used in the treatment of alcoholism.[1][2] A variety of other drugs cause disulfiram-like reactions upon consumption of alcohol as unintended drug interactions and side effects.[1][2] Many disulfiram-like drugs act as inhibitors of acetaldehyde dehydrogenase similarly to disulfiram. However, some do not act via inhibition of this enzyme, and instead act via other, poorly elucidated mechanisms.

Unlike acetaldehyde dehydrogenase inhibitors and other disulfiram-like drugs, alcohol dehydrogenase inhibitors such as fomepizole (brand name Antizol) inhibit the metabolism of alcohol into acetaldehyde, thereby increasing and extending the effects of alcohol and reducing its toxicity.[4] As such, they can be thought of as converses of disulfiram-like drugs.[4] Fomepizole is used medically as an antidote against methanol and ethylene glycol poisoning.[4]

  1. ^ a b c d Cite error: The named reference MarxWalls2013 was invoked but never defined (see the help page).
  2. ^ a b c d Fraser AG (1997). "Pharmacokinetic interactions between alcohol and other drugs". Clin Pharmacokinet. 33 (2): 79–90. doi:10.2165/00003088-199733020-00001. PMID 9260032. S2CID 45547473.
  3. ^ Mutalik, M., & Sanghavi, D. (2014). Review of Drug Interactions: A Comprehensive Update.
  4. ^ a b c McMartin K, Jacobsen D, Hovda KE (2016). "Antidotes for poisoning by alcohols that form toxic metabolites". Br J Clin Pharmacol. 81 (3): 505–15. doi:10.1111/bcp.12824. PMC 4767193. PMID 26551875.